Wednesday, October 31, 2007

"For those of us who had spent every day of the past 10 years completely wasted, even the idea of getting through a couple of days without drugs felt like some kind of miracle."

Twenty years ago, Will Keighley started on the road to recovery from addiction. Now he wonders whether he will be the last survivor of his Narcotics Anonymous group.

It was a very English funeral. Half-stifled tears in a small church in Essex; professional pall-bearers with professionally solemn faces; a slightly awkward, tentative address from an older brother; solid Victorian hymns that sang of a triumph over death that no one really felt. Apart from the two heart-breaking readings from his children, I'm not sure Adam would have recognised his own funeral. But then, funerals are for the living, and this was the way his family had chosen to say their goodbyes. And when it is such a pointlessly early death - Adam was 52 - there probably isn't a right way of saying goodbye.

I hadn't seen Adam for four or five years before he died. I had wondered, though, why he had stopped replying to my Christmas cards. Then I heard rumours that he was using again. At first, I didn't want to believe them; he had been clean for more than 15 years and had always seemed so strong. But when he ended up in intensive care with acute renal failure and was given less than 24 hours to live, I was forced out of my denial.

He had been living alone, having lost his marriage and his job, and had been taking anything and everything he could lay his hands on. In his usual perverse way, Adam survived another 18 months or so. He flirted with recovery and his family tried everything they could to help, from taking him in to kicking him out, but the self-destruct button was full on. He was found dead from an overdose, alone in a rundown basement flat, a few weeks ago.

Adam and I had been members of the Narcotics Anonymous (NA) class of '87. We hadn't known each other while we were using, but we spent a great deal of time together when we first cleaned up. We were the wrong side of 30, had been junkies for the best part of 10 years, were unemployed and, to all intents and purposes, unemployable. So we would get up late, go to a lunchtime NA meeting, hang out in coffee bars and snooker halls, maybe catch another NA meeting in the evening and go home.

Back in 1987, NA wasn't that big. It had been founded in the UK seven years previously by a few recovering addicts who had split away from Alcoholics Anonymous. There were probably only about 100 regular faces in London. It may have looked to an outsider like a large, dysfunctional family, but it kind of worked. Status was measured in clean time. The very few who had made it to seven years clean were gods; the small number with five years were living legends; even those with two or three years got big respect. And they deserved it. For those of us who had spent every day of the past 10 years completely wasted, even the idea of getting through a couple of days without drugs felt like some kind of miracle. I had come to NA through a rehab centre. The first two weeks had been spent without sleep, sweating, shaking, cramping and shitting as I went cold turkey. The next two were spent in intensive group therapy but only one session stands out: the counsellor eyeballed us - we were probably annoying her - and said: "Take a look around you. Statistically speaking, 30% of you will be dead within 10 years. That's how serious this disease is."

I've thought about that statement a lot over the years. At the time, we all laughed - albeit nervously. We thought it was the kind of shock-jock crap that counsellors were paid to threaten us with, to frighten us into staying clean. Since then, I've come to wonder whether she wasn't rather conservative.

The first few deaths didn't affect me that much. They were addicts who had flirted with recovery but always left you with the feeling they were keeping their options open. I hadn't got to know them - the NA motto "Stick with the winners" had become my mantra.

Harder to bear

Recovering addicts are generally judgmental, and drugs were a black-and-white issue. If you were clean, you were on the side of the angels; if you were using, you deserved what you got. Somebody overdosing was a modern morality tale - both a kick up the arse to remind you of the consequences of using and a pat on the back for not having done so.

As the years passed, it got harder to bear. Maybe I had developed a little compassion, maybe the deaths were closer to home, or maybe the body count was just getting frightening. Many of us had shared needles at some point, so an Aids test became a logical part of the recovery process. Many of us were lucky, but a significant number weren't.

After the initial shock of diagnosis, most HIV-positive addicts seemed to cope well. Most got jobs and talked of being grateful for being able to extend their lives by cleaning up. But back in the late 80s and early 90s there were no retrovirals, and people, including several close friends whom I had known almost from day one in NA, started to get sick and die.

There were no tearful, bedside farewells surrounded by family for Nico. He reached the stage where he couldn't hack it any more and killed himself in the bath. Then there was Paulo, who had befriended me and let me sleep on his sofa until I could find somewhere to live. He had had good jobs, but once Aids took hold of him he fell to pieces. First, he disappeared back to Italy to take as much smack as he could, and then he returned to England. I didn't recognise him the last time I saw him; all his teeth had fallen out and he was utterly emaciated. The Terrence Higgins Trust found him a flat, but he couldn't really cope. He was furious with life and furious with Aids and addiction. He committed suicide alone, having first smeared the walls of his bedroom with shit.

There were other suicides, people who couldn't stand the thought of going back to using but who couldn't handle the pain of living. Those were really hard to take. Then there were those who died prematurely from cancer and heart disease. Their postmortems probably put the cause of death down to natural causes, but I found it hard to see it that way; no one I knew who hadn't thoroughly abused their bodies with drugs, booze and fags was dropping dead from these diseases in their 30s and 40s.

The number of Aids deaths had tailed off by the late 1990s, but there followed a new disease on the NA block: hepatitis C. About 50% of those who had used needles were infected and no one quite knew what the prognosis was. They still don't, really. A few people have died from liver disease, some have been treated with combination drug therapies and appear to be clear of the virus, and a great many appear for the time being to be walking wounded. They don't seem to be getting much worse, but are permanently tired.

Then there are the people like Adam - people with years and years of clean time, who have worked hard to build meaningful lives for themselves, and then decide they can't really cope after all. It's these that get to me the most, because it really does look as though there's no escape from addiction. It doesn't matter what you have done or how long you've been in recovery, play one wrong hand and the whole deck collapses.

I'm sure there are addicts who have started smoking dope and drinking again and are doing OK. But it seems a hell of a gamble for them to take. I couldn't predict what would happen to me if I started using again - though I've a pretty good guess - so how can they? And if they do get away with it, what are they getting away with? Imagine what it must be like to live in the knowledge that things could go pear-shaped at any time.

I'm no longer bothered by the esoteric debates that go on in social policy about whether addiction is a disease or not - it feels like a minor intellectual distraction. I'm not much interested in the political battles on how best to treat addicts, as every suggestion I've heard sounds like another useless sticking plaster on a huge festering wound. There are no guarantees or easy treatments for addicts.

None unscathed

Back in 1987, Adam, Paulo, Nico and I thought we were the lucky ones. We were the survivors who had found recovery. And maybe we were lucky. I've no idea what happened to most of the people I took heroin with, but I'm sure that most must be dead if they didn't manage to stop. Doctors had given me six months to live if I didn't get my life together, and I was no better or worse than many.

Twenty years on, the mortality rate of those attending the NA meetings in 1987 is horrifying. Even the survivors haven't come out unscathed. I and several others have been in institutions for mentally ill people and have struggled with depression; many others have been in therapy for years, still trying to piece together fractured lives and relationships.

If this was cancer, the rate of attrition would be a national scandal. But it's just a bunch of junkies and alkies fucking themselves up, so no harm done. I'm increasingly beginning to wonder if I'm not in some bizarre reality freak show to find the last man standing.